New Guidelines Advise Against Routine Pelvic Exams at the Gyno

Turns out they're not that beneficial after all

Let us begin by congratulating you for scheduling routine gyno appointments. It's the responsible thing to do, so props on making that happen—especially because you probably shiver at the mere thought of getting your routine pelvic exam, which are the bimanual exams where your gyno checks your pelvic area (vulva, vagina, cervix, uterus, rectum and pelvis) to look for any abnormalities. Well, here's some surprising news: New guidelines published in theAnnals of Internal Medicine on Monday say that physicians actually should not offer routine pelvic exams to asymptomatic, average risk, non-pregnant women.

Kind of shocking, right? But the research found that these exams actually have limited benefits, they don't reduce mortality, and they rarely detect important diseases. What's more, they're associated with discomfort (um, yes) and false positives, not to mention extra cost. The national medical bill for the yearly pelvic exam is about $2.6 billion, and that doesn't even include the costs of follow-up medical visits and invasive tests that you may need to get if they find something suspicious.

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But listen up: This "don't test" recommendation only applies to the routine bimanual pelvic exam—not to Pap smear screenings or HPV tests. According to the most recent recommendations, women between 21 and 65 should get a Pap smear every three years as long as their last test was normal. The FDA also approved a new HPV test this year, which can be done in place of a routine Pap smear for women 25 and older. So essentially, this new recommendation isn’t an excuse to skip the gyno entirely.

Plus, there are times when you definitely should ask your doctor for the pelvic exam. The crucial distinction here is that these guidelines are focused solely on non-pregnant, asymptomatic women—i.e. women who don’t show any signs of cervical cancer and aren't coming into the office with troubling symptoms. So if you're seeing your gyno for any particular concern—like pelvic pain, irregular discharge, or bleeding, they should still do a pelvic exam to determine the cause.

While this news may prompt a big sigh of relief from some women, not everyone is happy with the new recommendation. In fact, the American College of Obstetrics and Gynecology (ACOG) released a statement yesterday to announce that they stand by their original guidelines of annual pelvic exams. In the statement, they "acknoweldge that no current scientific evidence supports or refutes an annual pelvic exam for an asymptomatic, low-risk patient, instead suggesting that the decision about whether to perform a pelvic examination be a shared decision between health care provider and patient, based on her own individual needs, requests and prefences."

They go on to explain some of the benefits of routine pelvic exams that are often things that can't be measured or proven in a study: "While not evidence-based, the use of pelvic exams is supported by the clinical experiences of gyncecologists treating their patients. Pelvic examinations also allow gynecologists to explain a patient's anatomy, reassure her of normalcy, and answer her specific questions, thus establishing open communication between patient and physician." Essentially, ACOG states that while there may not be a proven need for annual exams, it should ultimately be something a doctor and patient decide on together.

Chances are this won't affect your next trip to the gyno, but it's possible that down the line you may have to ask for a routine pelvic exam if you want one and your doctor doesn't suggest it based on your medical history.

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